血清脂蛋白(a)与缺血性脑卒中

A Study on the Relationship between Lp(a) and Arteriosclerotic Cerebral Infarction

采用 1∶1配比病例对照研究方法 ,对 10 5对缺血性脑卒中病人和非脑卒中的对照组病人 ,进行了血清脂蛋白 (a)、总胆固醇、甘油三脂、高密度脂蛋白胆固醇和低密度脂蛋白胆固醇的检测和分析 ,以评价它们与缺血性脑卒中的关系。结果显示 :病例组血清脂蛋白 (a)平均值为2 38.37mg/L ,明显高于对照组的 149.98mg/L ,t=3.97,P <0 .0 0 1,不同年龄组的比较中 ,只有 70岁以上年龄组血清脂蛋白 (a)明显高于 50岁以下年龄组 ,而性别在病例组内或对照组内均无显著性差异 ,将血清脂蛋白 (a)按不同等级进行分析 ,发现随着血清脂蛋白 (a)水平升高 ,缺血性脑卒中的危险性逐渐增加 ,有明显的剂量效应关系 ,多因素logistic回归分析表明 ,血清脂蛋白 (a)为缺血性脑卒中的独立危险因素 ,OR =1.93,其他危险因素还包括甘油三脂 ,而高密度脂蛋白胆固醇是缺血性脑卒中的保护因素 ,OR =0 .32。

Using a 1∶1 matched case control study,we analysed the data of 105 arteriosclerotic cerebral infarction cases and controls to detect the levels of TC,TG,HDL C,LDL C and Lp(a).The results showed that the average level of Lp(a) in cases was (238.38mg/L),significantly higher than that of controls (149.98mg/L t =3.96, P <0.001). Comparing the levels of different age groups and sex,no significant difference,except the group over 70 years,which was higher than that in other groups was found. Dose response analysis also showed that the OR value was positively correlated with the Lp(a).Multi variable logistic regression model indicated that Lp(a) was an independent risk factor with OR =1.93. Another risk factor was TG. However,LDL C.HDL C were found to be the protective factors of arteriosclerotic cerebral infarction, with an OR =0.32.